TX Propose Changes To Pharmacy Closed Formulary And Interlocutory Orders

Austin, TX (CompNewsNetwork) - The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) is accepting public comment on the proposal to amend 28 Texas Administrative Code (TAC) §134.500 and §134.506 and add new 28 TAC §§134.510, 134.520, 134.530, 134.540, and 134.550 regarding the Pharmacy Closed Formulary and to amend 28 TAC §133.306 regarding Interlocutory Orders for Medical Benefits. The proposal was published in the July 16, 2010 issue of the Texas Register and may be viewed on the TDI website at www.tdi.state.tx.us/wc/rules/proposedrules/index.html. The public comment period closes Monday, August 16, 2010 at 5 p.m. Central Standard Time (CST).
Public comments may be submitted to the TDI-DWC by e-mailing rulecomments@tdi.state.tx.us or by mailing or delivering the comments to Maria Jimenez at:
Texas Department of Insurance, Division of Workers' Compensation
Workers' Compensation Counsel, MS - 4D
7551 Metro Center Drive, Suite 100
Austin, Texas 78744 -1645
A public hearing on this proposal will be held on Monday, August 16, 2010 at 9 a.m. (CST) in the Tippy Foster Room of the TDI-DWC Central Office, 7551 Metro Center Drive, Suite 100 in Austin. Written and oral comments presented at the public hearing will be considered by the TDI-DWC. The TDI-DWC provides reasonable accommodations for persons attending meetings, hearings, or educational events, as required by the Americans with Disabilities Act. If you require accommodations in order to attend the public hearing, contact Idalia Salazar at 512-804-4403 at least two business days prior to the public hearing date.
The public hearing will also be audio streamed. To listen to the audio stream, access the TDI Agency Calendar at http://www.tdi.state.tx.us/alert/events.html and then click on the “Broadcast” link for the public hearing. Media Player 7 (or new version) or RealPlayer 10 (or newer version) are required to hear the audio stream. Audio streaming will begin approximately five minutes before the scheduled time of the public hearing.
The purpose of these proposed rules is to comply with the requirements of House Bill 7, 79th Legislature, Regular Session (effective September 1, 2005), which requires the adoption of a pharmacy closed formulary pursuant to Texas Labor Code §408.028(b). These rule proposals apply to both certified workers' compensation network and non-network claims. The proposals are anticipated to bring more uniformity and cost certainty to prescribing medication to injured employees subject to the Texas workers' compensation system and better coordinates health care pursuant to certified networks' treatment guidelines and the TDI-DWC's treatment guidelines for non-network claims. The proposals are also anticipated to establish a process in which interlocutory orders may be entered when an unreasonable risk of a potential medical emergency is present thereby safe-guarding the delivery of medically necessary medications to injured employees.
As a result of the proposed amendment to the rule relating to interlocutory orders for medical benefits, a new form, Medical Interlocutory Order Request Form for Drug Previously Prescribed and Dispensed and Not Currently in the TDI-DWC's Formulary (DWC Form-064), is being proposed. TDI-DWC is accepting public comment on the draft form until Monday, August 16, 2010 at 5 p.m. (CST). The draft form may be viewed on the TDI website at http://www.tdi.state.tx.us/wc/rules/proposedrules/index.html with the proposed rules.
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